When transporting a trauma patient by air in a nonpressurized cabin, certain precautions should be taken to ensure adequate ventilation and oxygenation.
Issues:
(1) expansion of gas with reduced barometric pressure
(2) reduce partial pressure of oxygen at higher altitudes
Parameter
Recommendation
airway tube (endotracheal or tracheostomy)
Use uncuffed airway if < 8 years of age. If cuffed tube in place, either fill cuff with water or adjust pressure with altitude.
trapped air (pneumothorax, pneumoperitoneum)
Fly at lowest possible altitude.
FIO2 of inspired air
see equation below
oxygenation
Use pulse oximeter.
gastric tube
Use nasogastric or orogastric tube to prevent gastric distention or vomiting.
FIO2 required at altitude =
= (FIO2 on ground) * (barometric pressure in mm Hg at ground) / (barometric pressure in mm Hg at altitude)
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